Very recently I was struck by news of a friend’s spouse contracting an incurable disease where the liver degenerates away. Watching his pain I began to wonder about and perhaps even hope that a certain magic would be possible. What if we could simply grow another organ from a human’s own cells? Or perhaps we could send in miniscule machines, perhaps even cells, to repair little by little the diseased organ. We could also coax the body to somehow grow and heal itself. Approaches along these lines are being attempted in laboratories for a variety of diseases that have proven intractable with conventional methods. Many of these ideas come around to the notion of life and health extension – can we extend the healthy lifespan of an individual to longer than was once thought possible. For the vast majority of people in industrial societies today, the average lifespan has more than doubled compared to a century ago. With such progress has emerged a challenge on an unforeseen scale.

Cancer

The longer you live, the more your cells must divide. The more your cells divide, the more they are exposed to chemicals, the more likely they would be to sustain an error in their genetic code. The wrong kind of error or perhaps too many errors building up over time can eventually lead to uncontrolled cell growth via disruption of one of the many pathways that stop unlimited proliferation of cells as well as eliminate rogue cells that are bypassing these checkpoints. The problem is that some cells eventually get through, given both an individuals genetic propensity for cancer and also the amount of carcinogens (chemicals, ultraviolet light, smoke etc) to which s/he has been exposed to. While there is a debate about the relative importance of intrinsic and extrinsic factors causing cancer, it is very clear that modern societies have increased levels of both risks. We live much longer than before. There are also far greater levels of pollutants, chemicals and what hae you in our air, food and water than ever before. Combine these two and you have a surefire recipe for cancer.

Many drugs, therapies and treatment regimes have been and continue to be developed for cancer. This is the disease of our times, ever present and ever increasing. But no matter how hard we try to defeat it, the disease comes back in a different guise. To understand how, consider that a cancer cell is one that will typically be able to mutate its genetic material with very few constraints. So every two daughter cells may be significantly altered from the one that gave rise to them.

A few generations down we may find that not just a few cells, but large parts of the tumour have genetic compositions that are very far from what they began with. This along with the fact that every individuals genetic makeup is unique presents doctor’s and scientists with an unusual problem to solve. A drug that starts out working may not continue to work. In fact there is no way to know that a drug will even start out by working without actually trying it on the patient.

Wouldn’t it be wonderful if a whole bunch of drugs could be tried out on the tumour in question before it being used full on? Scientists have come up with a way which will revolutionise the process of treating difficult diseases if only we can manage to deal with the ethical minefields involved. Imagine that you could create a hundred “you”s. All captive and with exactly the same disease as you. One drug each is first tested on these clones. You pick the drug that can be demonstrated to work best in these clones and discard the ones that do not. The clone’s continue to be treated with exactly the same treatment regimen as you. As soon as the treatment stops working you repeat the process or you reclone yourself and find the drugs that work. Repeat as necessary.

For the vast majority of people, human cloning is one step too far. So another way has been developed by scientists. Consider that you can replicate your disease in some other animal model system. Mice have been preferred for such research but they are expensive to maintain and take a long time to yield a result. Researchers from Portugal led by Rita Fior and Miguel Godinho Ferreira have now ported these ideas to a tiny fish – the zebrafish – that is popular with geneticists. Human tumors recreated in the fish behaved similar to those in the mice. But more importantly they followed a very similar course to those in humans when treated with drugs meant for humans. For the first time in human history we are within realistic striking distance of producing avaatar’s of complex human diseases where trial and error can be used to compensate for our lack of understanding.

A huge step forward for science as well as medicine. So much so that I suspect our societies will find creative ways to ignore the ethics of such treatments to advance the cause of humankind.

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